CPC: Major Bleed

Question 1

Give the 3 definitions of a major haemorrhage [3]

Answer 1

1. Loss of more than one blood volume within 24 hours (around 70 mL/kg, >5 litres in a 70 kg adult)
2. 50% of total blood volume lost in less than 3 hours
3. Bleeding in excess of 150 mL/minute

Question 2

What are the potential complications of a major haemorrhage? [4]

Answer 2

1. Hypothermia
2. Acidosis
   
   • monitor with blood gases
3. Coagulopathy
4. Hypocalcaemia
   
   • check ionised Ca2+ on blood gas and replace

Question 3

How should a patient with a major haemorrhage be managed? [7]

Answer 3

1. ABC
2. Oxygen
3. Monitoring
4. IV access
5. Bloods — FBC, Coag, fibrinogen, U&E, LFT, Ca²⁺
6. Tranexamic Acid (if trauma < 3 hrs ago)
7. KEEP PATIENT WARM